Antimicrobial resistance is a growing problem that threatens treatment of infectious diseases and numerous medical procedures. It is well known that the introduction of new antibiotics is slow and costly. In consequence, this proposal concentrates on a critical aspect of the fight against the problem of bacterial resistance to antibiotics: the search for strategies aimed at preserving the effectiveness of currently available drugs. Our model system is the aminoglycoside 6'-N-acetyltransferase type Ib [AAC(6')-Ib], the most clinically relevant acetyltransferase among gram-negative pathogens, which mediates resistance to amikacin (Ak) and other aminoglycosides. These antibiotics are an important component of the armamentarium against serious infections caused by several gram-negative pathogens. The long term goal of this research is to develop pharmacological tools that in combination with Ak overcome the presence of aac(6')-Ib and can be successfully used to treat Ak-resistant infections. We have identified oligoribonucleotide sequences, known as external guide sequences (EGSs), that elicit RNase P-mediated cleavage of aac(6')-Ib and ftsZ mRNA and result in a reduction of the levels of resistance to Ak and inhibition of cell division, respectively. Furthermore, we determined that nuclease resistant oligoribonucleotide analogs composed of locked nucleic acids and deoxyribonucleotide monomers (LNA/DNA) behave as EGSs. One aim of this project is to generate efficient LNA/DNA EGSs that can penetrate the cells and inhibit expression of the resistance gene aac(6')-Ib. These compounds will be used in combination with Ak (LNA/DNA EGSaac/Ak) to achieve phenotypic conversion to susceptibility to Ak. However since a common problem of antisense strategies is that the inhibitory activity is not potent enough for an effective antimicrobial effect we will design compounds that act synergistically with the mix LNA/DNA EGSaac/Ak. We will identify inhibitors of AAC(6')-Ib that will eliminate the activity of any enzyme produced by residual expression of the resistance gene. We will also design LNA/DNA EGSs that will interfere with expression of the E. coli and A. baumannii essential cell division protein FtsZ by eliciting RNase P-cleavage of ftsZ mRNA genes. Combinations consisting of the mix LNA/DNA EGSaac/Ak plus an AAC(6')-Ib inhibitor and/or an LNA/DNA EGS targeting ftsZ will be tested to determine their ability to inhibit growth of E. coli and A. baumannii harboring aac(6')-Ib.